When I was my daughter’s age, there were just five TV channels and no such thing as PCs, Tivo, DVD or even VCR.  Many of my favorite programs were black-and-white and cartoons were shown only on Saturday morning.  

Today, from the youngest of ages, we stimulate our children with a seemingly endless stream of multimedia presentations.  As a result, they get smarter faster.  They also get bored more easily, and that makes the job of the classroom teacher even tougher.

This afternoon I was privileged to attend a training program for Gwinnett County administrators and teachers conducted by Creating Pride.  The program is called ArtsNOW but is not so much about teaching art as it is using art to teach other subjects. 

I observed two of the four workshops.  One, led by an instructor from the Savannah College of Art and Design, dealt with the use self-portrait to teach, among other things, mathematical proportions.  The other, taught by a theater professor from Emory University, sought a classroom application for the ancients art of story telling and play acting. 

I spoke briefly at the opening session.  I talked about how art had been used by the very first humans not just for pleasure but to record knowledge, chronicle triumphs and calamaities and express hopes and dreams.  Cultures have disappeared and languages have been forgotten, but we can look at prehistoric cave etchings and ancient monuments and know what our ancestors were trying to say.

Bolstered by my experience today, I am convinced that art has a practical application in helping our teachers teach and children learn.

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I called up Grady’s Otis Story about a month ago and began the conversation by saying, “I know it might not seem this way to you, but I am trying to help.”  I have met with him more than once in the last several weeks, and I am impressed with him.  I believe that he is committed to Grady as an institution and is willing to fight for its reform.

I agree with everything he said in this AJC guest column about the Disproportionate Share Hospital program.  DSH is neither the cause of Grady’s problems nor the magic bullet that will solve them, but Mr. Story is right when he says that Grady has been adversely and unfairly impacted by all the fiddling with the DSH formula. 

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DeKalb County Commissioner Elaine Boyer has offered a resolution outlining a framework for renegotiating the financial relationship between Emory University and Grady Hospital.  In her plan:

1.  Emory would forebear inadequately documented bills, eliminating debt from Grady’s balance sheet and giving the troubled hospital much needed breathing room.

2.  Grady and Emory would implement audit recommendations requiring full documentation of all future bills.  Grady’s auditors say that new documentation procedures would not only help Grady financially but improve the quality of patient care.  Full documentation would also end the discriminatory treatment of Morehouse doctors who are inexplicably required to provide six times as much documentation of their time than Emory doctors.

3.  Emory would assume liability for its own malpractice.  Not only would this save Grady millions of dollars each year defending and settling lawsuits against Emory employees, it would bring the Emory-Grady contract in line with best practices and likely improve the quality of patient care. 

4.  A new Emory-Grady contract would be negotiated recognizing Grady’s in-kind value to Emory as both a tool to attract tuition-paying students and a source of patient and research revenue.

Commissioner Boyer’s resolution expands on an earlier resolution offered by two of her colleagues, Commissioners Larry Johnson and Connie Stokes.  The Johnson-Stokes resolution called for reductions in payments to Emory based on Grady’s in-kind value to Emory.

I am hopeful the DeKalb County resolution will pass the full Board, but Grady should not wait for that happen.  It should move now to restructure its relationship with Emory along the lines suggested by Commissioners Boyer, Stokes and Johnson.

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Last week I wrote a letter to Commissioner of Community Health Rhonda Medows about the Disproportionate Share Hospital (DSH) program, popularly called “Dish.”

My letter has ramifications for Grady, but I would have written it whether Grady was in trouble or not.

DSH is a federal program designed to aid public hospitals that provide a “disproportionate share” of care to the indigent, hence its name.  But Georgia and many other states have instead been using DSH to subsidize health care delivery across-the-board.

When the program began, only a handful of Georgia hospitals were eligible for DSH funding.  But eligibility has been expanded to the point that hospitals can draw DSH funds without providing a single dollar of uncompensated indigent care.  Now virtually every hospital in the state is drawing DSH funds, and that means that those hospitals that are truly providing “disproportionate” care are being shortchanged.

To its credit, the Department has proposed a new formula that would allocate DSH funds according to the percentage of uncompensated indigent care provided.  Unfortunately, the new formula includes self-defeating ”stop loss” provisions which effectively prevent it from taking effect.

I am not unsympathetic to the larger issues confronting the health care delivery system, particularly in rural Georgia.  Medicaid reimbursement rates, which currently cover only 85% of the cost of a service, should be addressed — but not by using the Disproportionate Share Hospital program as an across-the-board subsidy.

Yes, Grady has been hurt by the redirection of DSH funds.  But as I told James Salzer of the AJC, Grady’s problems are bigger than this one program, and those problems cannot be solved with money alone.  Saving Grady will require a combination of governance, contract and culture reform, and all three must be vigorously pursued. 

Conversely, the issue of DSH funding is bigger than Grady.  As a matter of principle, we should avoid using funds set aside for one program to fulfill the purposes of another.  Medicaid and DSH funding are separate issues, and they should each be addressed on their own merits.

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Grady Memorial Hospital is named for Henry W. Grady, a former publisher of the The Atlanta Constitution.  His successors and my good friends at the AJC are full of ideas on how to save his namesake hospital.  They all involve someone else writing a check and not asking many questions before signing it. 

Several weeks ago, Cynthia Tucker wrote this gem, saying that while she had no real disagreement with my proposals for Grady governance reform, the fact that I was “white, male, consevative and Republican” disqualified me from participating in the debate.  My role should be limited to mutely voting in favor of a government bailout.  It was so outrageous that bloggers across the political spectrum rallied to my defense.

Now Mike King has penned his version of the Tucker column.  It is far less crass.  He complains more broadly about the state legislators and county commissioners who have only recently begun paying attention to Grady.  He wants us to set aside any ”distracting” investigation into Grady’s problems until after the hospital has been saved.

I do not want to be too hard on Mike.  For one thing, he has written a number of excellent editorials about the problems at Grady.  I have shared his columns with other legislators, and we have even linked to them at the Reforming Grady Dot Org website.  He and I have talked privately about Grady, and over the last several months, exchanged a dozen or so emails.  He has been generous with his research and free with his opinions, and I am frankly grateful for his help.  Also, he is not nearly as pompous in person as you would expect from his writing.

But it is ridiculous for him to suggest that contract and culture reform are “sideshows” to Grady’s “revivial.”  They are central to saving the hospital.  Just like you cannot fix a leaky bucket by refilling it with water, you cannot save Grady with money alone.  It takes governance, contract and culture reform, and those cannot “wait.”

I emailed Mike last week offering to write a guest column of rebuttal.  No response as of yet.

Alternatively, I asked him to correct a glaring error in his column.  He stated that I had sought (“chased” was his word) court records in “unsuccessful” lawsuits filed by two different whistleblowers.  In fact, I have only asked for the records in one case, and it involved a $1.6 million settlement with the whistleblower. No response on the requested correction either.

With paid readership down dramatically, I doubt the AJC is in much of a position to help Grady financially.  But the paper has an important role to play, if only it were willing.  Instead of dumping on the elected officials who are trying to get to the bottom of the problems at Grady, its reporters and editorialists should be helping.

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Two of my daughter’s kindergarten classmates celebrated birthdays this weekend, and it was my fatherly privilege to accompany her to the parties.  At the party earlier today, she and the other party guests were able to “build” and outfit their own stuffed teddy bears.  She named hers “Good Luck” but calls him “Good” because “that is the first name.” At the party yesterday, entertainment was provided by Magnificent Mike, a magician, and Sassy, a clown and face painter. 

I do not remember the parties being that elaborate when I was in kindergarten.  When I was in the third grade, I celebrated a birthday at Goofy Golf, a putt putt golf course, but when I was in kindergarten, all I remember from my 5th birthday party was a contest in which we all competed to roll round clothes pins across the floor of the play room with our noses.

Of course, my daughter is a lot more advanced than I was at her age.  I vividly remember the pride I experienced when I first counted to 20, and it was sometime near the very end of my year in kindergarten.  Before my daughter even entered what is now called K5, she could count to 100, say the alphabet and reel off the months of the year in two different languages.  I only know the months in one language myself.

But as smart as they may be, they are still kids.

We had decided to take my daughter to Disney World for her birthday this year, but in planning the trip, I came across the astounding statistic that the number one thing six year olds remember about their Disney World visit is the “hotel swimming pool.”  The next time she brought up Disney World, I slyly asked her what about the trip she was looking forward to most.  She responded, “Jumping on the bed and ordering room service.”

We moved Disney World back a year and invited all her friends to a local party center where they could jump on oversized inflatable jumping pads.  No clothes pin races for her or her friends.

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The AJC today reported the good news that Lake Lanier holds more water than originally believed.  But before you relax with a long shower, read beyond the headline.  The operations manager for the Army Corps of Engineers has clarified that instead of running out of water in 81 days, “we can can still supply enough water for us to live on for at least several months.”

Earlier in the week, an AJC guest columnist urged that Corps continue pumping water down the Chattahoochee River, arguing that the “mussels should not be sacrificied” because of poor planning by humans.  He makes worthwhile points about the importance of conservation and managing growth, but misses the larger point that the both humans and mussels are facing the same immediate danger — drought.  Lake Lanier is an artificial reservoir, constructed by the humans.  That reservoir is now being drained by the Corps of Engineers for the benefit of the mussels.  It is human planning that is saving the mussel, not endangering it.  And frankly, that makes little sense, if done to the detriment of the humans.

The potential loss of Grady Memorial Hospital has been rightly described as a ”disaster” for the metro Atlanta region.  But the loss of Grady pales in comparison to the emptying of Lake Lanier.  Without water, metro Atlanta faces a public health crisis of an unprecedented magnitude.

I wholly support Governor Perdue’s suit to stop the Corps from draining the lake. 

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I have never actually called him “Shack.”  But I was nonetheless privileged to participate in a luncheon yesterday honoring Wayne Shackelford, Georgia’s former Commissioner of Transportation and Gwinnett County’s former County Administrator.

The interchange of I-85 and SR 316, in the heart of Gwinnett County and scheduled for completion early next year, will be named in his honor.

The idea originated with Emory Morsberger, who organized the luncheon and penned this tribute to Mr. Shackelford.

Several of Mr. Shackelford’s longtime friends spoke, and I read a resolution honoring his many accomplishments.  Every member of the State Board of Transportation attended, some looking a little weary after the grueling selection of a new DOT Commissioner.

Camie Young from the Gwinnett Daily Post wrote this article covering the luncheon. 

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Six minutes that will help you put everything in perspective: 

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I spent a good deal of my career as a political operative trying, without success, to defeat Zell Miller.  When I was executive director of the Georgia Republican Party in the early 1990s, I helped recruit Guy Millner to challenge him for re-election as Governor.  I even left my job at the party to manage Guy’s campaign.  In 2000, when Zell ran in the special election to fill the late Paul Coverdell’s term as United States Senator, I supported Mack Mattingly, serving as his volunteer campaign treasurer.

Perhaps that is why I reacted differently than most Republicans to Senator Zell Miller’s de facto conversion to the Republican Party.  I treated the whole business with bemused skepticism.  This is a man, after all, who had earned the nickname Zig Zag before I was old enough to vote.

But I was still looking forward to Zell’s speech at Georgia Right To Life’s Changing Hearts and Saving Lives Celebration.   I was expecting to be entertained and instead found myself being both moved and challenged.

The former Governor and United States Senator began by tracing his religious roots to the mountain churches of North Georgia.  He spoke frankly about the challenges of reconciling one’s religious faith with the demands of political expediency.  Church attendance is the easy part, he said.  Applying those principles in everyday life is the hard part.

As Governor, Zell Miller had a pretty good pro-life record.  He signed laws banning partial-birth abortion and requiring parental consent for a minor to obtain an abortion.  But in his speech, he dismissed these important pro-life accomplishments, saying he had done what he did because the polls suggested it was smart, not because his heart told him it was right.

His path to the Changing Hearts and Saving Lives Celebration was marked by a family medical tragedy that forced him to his knees in prayer and a grainy image of his unborn grandchild produced by the wonders of modern technology.  He talked about Baby Samuel, a “nonviable” 21 week old fetus from Villa Rica, Georgia, whose spina bifida corrective surgery was photographed by USA Today.  Science had compellingly confirmed to him what so many believe as an article of faith — that the fetus is a human being and not a mere clump of cells.

It was a good speech, and it earned him a standing ovation.  It also gave me pause to consider my own cynicism.  Zell Miller is not running for office.  He is not looking for votes or volunteers.  He was not paid a speaking fee, awarded an honorary degree or even given a plaque.  That 75 year old man had absolutely no reason to leave his beloved home in the mountains and brave the Atlanta traffic other than he believed strongly in what he had to say.

I am glad I was there to listen, and much to my surprise, I found myself wishing that his days in public office were not over.

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